Search results for: intermittent fasting

Authors: Rami Al Jafar, Paul Elliott, Konstantinos K. Tsilidis, Abbas Dehghan

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Although Ramadan fasting is a ritual that is practiced every year by millions of Muslims, studies on Ramadan fasting are still scarce. To the best of our knowledge, none of the previous studies comprehensively explored the effect on the metabolic profile. In London Ramadan Fasting Study, blood samples were collected from 81 participants before and 10-14 days after Ramadan. Blood samples were analysed using nuclear magnetic resonance (NMR) spectroscopy which covers 249 metabolites. Mixed-effects models were used to analyse collected data and assess the effect of Ramadan fasting on the metabolic profile. Our observational study involved 85 individuals with a mean age of 45.2 years, and 53.1% of them were males. After Ramadan, forty metabolites were affected significantly by Ramadan fasting. Most of these metabolites were metabolites ratios (24), and the rest were three Glycolysis, three ketone bodies, nine Lipoprotein subclasses and one inflammation marker. This study suggests that Ramadan fasting is significantly associated with changes in the metabolic profile. However, the changes are assumed to be temporary, and the long-term effect of these changes is unknown.

Keywords: metabolic profile, Ramadan fasting, metabolites, intermittent fasting

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Authors: Hafiz Arbab Sakandar

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Time-restricted intermittent fasting (TRIF) impacts host’s physiology and health. Plenty of health benefits have been reported for TRIF in animal models. However, limited studies have been conducted on humans especially in underdeveloped economies. Here, we designed a study to investigate the impact of TRIF/Ramadan fasting (16:8) on the modulation of gut-microbiome structure, metabolic pathways, and predicted metabolites and explored the correlation among them at different time points (during and after the month of Ramadan) in Pakistani Expats living in China. We observed different trends of Shannon-Wiener index in different subjects; however, all subjects showed substantial change in bacterial diversity with the progression of TRIF. Moreover, the changes in gut microbial structure by the end of TRIF were higher vis-a-vis in the beginning, significant difference was observed among individuals. Additionally, metabolic pathways analysis revealed that amino acid, carbohydrate and energy metabolism, glycan biosynthesis metabolism of cofactors and vitamins were significantly affected by TRIF. Pyridoxamine, glutamate, citrulline, arachidonic acid, and short chain fatty acid showed substantial difference at different time points based on the predicted metabolism. In conclusion, these results contribute to further our understanding about the key relationship among, dietary intervention (TRIF), gut microbiome structure and function. The preliminary results from study demonstrate significant potential for elucidating the mechanisms underlying gut microbiome stability and enhancing the effectiveness of microbiome-tailored interventions among the Pakistani populace. Nonetheless, extensive, and rigorous large-scale research on the Pakistani population is necessary to expound on the association between diet, gut microbiome, and overall health.

Keywords: gut microbiome, health, fasting, functionality

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Authors: Turki J. Alharbi, Jencia Wong, Dennis Yue, Tania P. Markovic, Julie Hetherington, Ted Wu, Belinda Brooks, Radhika Seimon, Alice Gibson, Stephanie L. Silviera, Amanda Sainsbury, Tanya J. Little

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Fasting has been practiced for centuries and is incorporated into the practices of different religions including Islam, whose followers intermittently fast throughout the month of Ramadan. Thus, Ramadan presents a unique model of prolonged intermittent fasting (IF). Despite a growing body of evidence for a cardio-metabolic and endocrine benefit of IF, detailed studies of the effects of IF on these indices in type 2 diabetes are scarce. We studied 5 subjects with type 2 diabetes (T2DM) and 7 healthy controls (C) at baseline (pre), and in the last week of Ramadan (post). Fasting circulating levels of glucose, HbA1c and lipids, as well as body composition (with DXA) and resting energy expenditure (REE) were measured. Plasma gut hormone levels and appetite responses to a mixed meal were also studied. Data are means±SEM. Ramadan decreased total fat mass (-907±92 g, p=0.001) and trunk fat (-778±190 g, p=0.014) in T2DM but not in controls, without any reductions in lean mass or REE. There was a trend towards a decline in plasma FFA in both groups. Ramadan had no effect on body weight, glycemia, blood pressure, or plasma lipids in either group. In T2DM only, the area under the curve for post-meal plasma ghrelin concentrations increased after Ramadan (pre:6632±1737 vs. post:9025±2518 pg/ml.min-1, p=0.045). Despite this increase in orexigenic ghrelin, subjective appetite scores were not altered by Ramadan. Meal-induced plasma concentrations of the satiety hormone pancreatic polypeptide did not change during Ramadan, but were higher in T2DM compared to controls (post: C: 23486±6677 vs. T2DM: 62193±6880 pg/ml.min-1, p=0.003. In conclusion, Ramadan, as a model for IF appears to have more favourable effects on body composition in T2DM, without adverse effects on metabolic control or subjective appetite. These data suggest that IF may be particularly beneficial in T2DM as a nutritional intervention. Larger studies are warranted.

Keywords: type 2 diabetes, obesity, intermittent fasting, appetite regulating hormones

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Authors: H. Alabed, K. Abuzayan. L. Fgie, K. Zarug

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Ramadan requires individuals to abstain from food and fluid intake between sunrise and sunset; physiological considerations predict that poorer mood, physical performance and mental performance will result. In addition, any difficulties will be worsened because preparations for fasting and recovery from it often mean that nocturnal sleep is decreased in length, and this independently affects mood and performance. A difficulty of interpretation in many studies is that the observed changes could be due to fasting but also to the decreased length of sleep and altered food and fluid intakes before and after the daytime fasting. These factors were separated in this study, which took place over three separate days and compared the effects of different durations of fasting (4, 8 or 16h) upon a wide variety of measures (including subjective and objective assessments of performance, body composition, dehydration and responses to a short bout of exercise) - but with an unchanged amount of nocturnal sleep, controlled supper the previous evening, controlled intakes at breakfast and daytime naps not being allowed. Many of the negative effects of fasting observed in previous studies were present in this experiment also. These findings indicate that fasting was responsible for many of the changes previously observed, though some effect of sleep loss, particularly if occurring on successive days (as would occur in Ramadan) cannot be excluded.

Keywords: drinking, eating, mental performance, physical performance, social activity, blood, sleepiness

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Authors: H. Alabed, K. Abuzayan, J. Ezarrugh, S. Ali, M. Touba

Abstract:

Ramadan requires individuals to abstain from food and fluid intake between sunrise and sunset, Physiological considerations predict that poorer mood, Physical performance and mental performance will result. In addition, Any difficulties will be worsened because preparations for fasting and recovery from it often mean that nocturnal sleep is decreased in length and this independently affects mood and performance. A difficulty of interpretation in many studies is that the observed changes could be due to fasting but also to the decreased length of sleep and altered food and fluid intakes before and after the daytime fasting. These factors were separated in this study, Which took place over three separate days and compared the effects of different durations of fasting (4, 8 or 16 h) upon a wide variety of measures (including subjective and objective assessments of performance, body composition, Dehydration and responses to a short bout of exercise) but with an unchanged amount of nocturnal sleep, Controlled supper the previous evening, Controlled intakes at breakfast and daytime naps not being allowed. Many of the negative effects of fasting observed in previous studies were present in this experiment also. These findings indicate that fasting was responsible for many of the changes previously observed, Though some effect of sleep loss, Particularly if occurring on successive days (as would occur in Ramadan) cannot be excluded.

Keywords: Drinking, eating, mental performance, physical performance, social activity, blood, sleepiness

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Authors: Gaby Fahmy

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The last decades have seen a rise in metabolic disorders like diabetes, obesity, and fatty liver disease around the world. Environmental factors, especially nutrition, have contributed to this increase. Additionally, pre-conceptional parental nutritional choices have been shown to result in epigenetic modifications affecting gene expression during the developmental process in-utero. These epigenetic modifications have also been seen to extend to the following offspring in a trans-generational effect. This further highlights the significance and relevance of epigenetics and epigenetic tags, which were previously thought to be stripped in newly formed embryos. Suitable prenatal nutrition may partially counteract adverse outcomes caused by exposures to environmental contaminants, ultimately resulting in improved metabolic profiles like body weight and glucose homeostasis. This was seen in patients who were given dietary interventions like restrictive caloric intake, intermittent fasting, and time-restricted feeding. Changes in nutrition are pivotal in the regulation of epigenetic modifications that are transgenerational. For example, dietary choices such as fatty foods vs. vegetables and nuts in fathers were shown to significantly affect sperm motility and volume. This was pivotal in understanding the importance of paternal inheritance. Further research in the field is needed as it remains unclear how many generations are affected by these changes.

Keywords: epigenetics, transgenerational, diet, fasting

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Authors: Rahil Sahragard, Mahmoud Hatami, Rostam Bahadori Khalili

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Diabetes is one of the most important health problems in the world and a chronic disease requiring continuous care and therefore, it is necessary for patients to undergo self-care and nutrition education. This study was conducted to evaluate the effect of nutrition education on the metabolic control of diabetic patients in Tehran in 2015. An experimental study was conducted on 100 patients who had previously been approved by a specialist physician for diabetes and at least one year after their onset. At first, patients without any knowledge of the educational program were selected as sample and from them a checklist containing demographic and specific information about diabetes was filled and were taken three fasting blood glucose and three times fasting blood glucose (5 p.m.) Then, the patients received face-to-face training in the same conditions for 2 weeks in a Mehregan hospital of Tehran, and received 3 months of training, while they were fully monitored and during this time, samples that had a cold or blood pressure-related disease or were admitted to the hospital were excluded from the study. After the end of the study, the checklist was filled again and 3 fasting blood glucose and 3 fasting blood glucose samples were taken, the results were statistically analyzed by MC Nemar's statistical test. The research findings were performed on 100 patients 41.7% male and 58.3% women, the range of age was between 22 and 60 years old, with a duration of diabetes ranging from 1 to 15 years. Abnormal fasting blood glucose from 95% to 48.3% (P <0.0001) and non-fasting blood glucose decreased from 91.6% to 71.2% (P <0.001). Research has shown that training on blood glucose control has been successful, therefore, it is recommended that more research is done in the field of education to help patients with diabetes more comfortable.

Keywords: nutrition education, diabetes, function, insulin, chronic, metabolic control

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Authors: Sheila R. Pai, N. K. Subbalakshmi, C. Vidya

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Background: Accumulating evidence from prospective studies suggests an increased risk of type 2 diabetes associated with sleep deprivation and sleep disorders. Shift work by disrupting the circadian rhythm, could possibly cause metabolic disturbances. Objective: To investigate the influence of shift work on fasting blood glucose in hospital workers population. Materials and Methods: This was a cross-sectional study including 90 night shift workers (study group) and 90 day workers (controls) drawn from paramedical personnel. Night shift work was on a forward rotation basis, with an average of one night shift every 4 weeks. Each night shift rotation was for a period of 7 days, with a total of 8 hours of shift work per night. In the entire subjects body mass index (BMI) and fasting blood sugar (FBS) was measured. Statistical analysis included unpaired t test, Mann-Whitney ‘U’ test and Chi-square test. P value less than 0.05 was considered significant. Result: The study and control groups were comparable with regard to age, sex distribution and duration of employment. FBS was higher in study group compared to controls (p < 0.0001). There was no significant difference in BMI between control and study group. Conclusion: Shift work may adversely influence glucose metabolism.

Keywords: shift work, fasting blood sugar, sleep disturbances, diabetes

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Authors: Nanhee Cho, Eugene Han, Hanbyul Kim, Hochan Cho

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Pre-diabetes includes impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) and there is a strong probability that pre-diabetes will lead to diabetes mellitus (DM). Serum fibroblast growth factor 21 (FGF-21) is known to be increased as a compensatory response to metabolic imbalance under conditions such as obesity, metabolic syndrome, and DM. This study aims to identify the relationship of serum FGF-21 with pre-diabetes, and with biomarkers of related metabolic diseases. Fifty five Korea adult patients participated in a cohort study from June 2012 to December 2015. The analysis revealed that BMI, FBS levels, and serum FGF-21 levels were significantly higher in the IFG group compared to those in the normal group. A multiple regression analysis was conduted on the correlations of serum FGF-21 levels with BMI, and FBS levels, and the result did not show statistical significance. In conclusion, our results revealed that serum FGF-21 level serve as a marker to predict IFG.

Keywords: cytokine, fibroblast growth factor 21, impaired fasting glucose, prediabetes

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Authors: Ahmed Assem Abd El Rahim

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Background: Mechanical low back pain is serious physical and social health problem. Purpose: To examine impact of shock wave therapy versus intermittent mechanical traction on mechanical LBP, and disabilities. Subjects: 60 mechanical LBP male studied cases years old 20-35 years were assigned randomly into 3 groups, Picked up from Sohag university orthopedic hospital outpatient clinic. Methods: (Study Group) A: 20 studied cases underwent shock wave therapy plus conventional physical therapy. (Study Group) B: twenty studied cases underwent intermittent mechanical traction plus conventional physical therapy. (Control Group) C: 20 patients underwent conventional physical therapy alone. Three sessions were applied weekly for four weeks. Pain was quantified using McGill Pain Questionnaire, Roland Morris Disability Questionnaire was used for measuring disability, and the ROM was evaluated by (BROM) device pre- & post-therapy. Results: Groups (A, B & C) found a reduction in pain & disability & rise in their in flexion and extension ROM after end of 4 weeks of program. Mean values of pain scale after therapy were 15.3, 9.47, and 23.07 in groups A, B, & C. mean values of Disability scale after therapy were 8.44, 4.87, 11.8in groups A, B & C. mean values of ROM of flexion were 25.53, 29.06, & 23.9 in groups A, B & C. mean values of ROM of extension were 11.73, 15.53 & 9.85 in groups A, B & C. studied cases who received intermittent mechanical traction & conventional physical therapy (group B), found reduction in pain & disability & improvement in ROM of flexion & extension value (P<0.001) after therapy program. Conclusion: Shock wave therapy and intermittent mechanical traction, as well as conventional physical treatment, can be beneficial in studied cases with mechanical LBP.

Keywords: mechanical low back pain, shock wave, mechanical, low back pain

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Authors: Izabela Zielinska

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Kinesio Taping is classified as physiotherapy method supporting rehabilitation and modulating some physiological processes. It is commonly used in sports medicine and orthopedics. This sensory method has influence on muscle function, pain sensation, intensifies lymphatic system as well as improves microcirculation. The aim of this study was to assess the effect of Kinesio Taping in patients with ongoing treatment of peripheral artery disease (PAD). The study group comprised 60 patients (stadium II B at Fontain's scale). All patients were divided into two groups (30 person/each), where 12 weeks long treadmill training was administrated. In the second group, the Kinesio Taping was applied to support the function of the gastrocnemius muscle. The measurements of distance and time until claudication pain, blood flow of arteries in lower limbs and ankle brachial index were taken under evaluation. Examination performed after Kinesio Taping therapy showed statistically significant increase in gait parameters and muscle strength in patients with intermittent claudication. The Kinesio Taping method has clinically significant effects on enhancement of pain-free distance and time until claudication pain in patients with peripheral artery disease. Kinesio Taping application can be used to support non-invasive treatment in patients with intermittent claudication. Kinesio Taping can be employed as an alternative way of therapy for patients with orthopedic or cardiac contraindications to be treated with treadmill training.

Keywords: intermittent claudication, kinesiotaping, peripheral artery disease, treadmill training

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Authors: Jongwoo Lee, Dae-Eun Kang, Sang-Young Park

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This study presents a precise relative navigational method for satellites flying in formation using laser-based intermittent measurement data. The measurement data for the relative navigation between two satellites consist of a relative distance measured by a laser instrument and relative attitude angles measured by attitude determination. The relative navigation solutions are estimated by both the Extended Kalman filter (EKF) and unscented Kalman filter (UKF). The solutions estimated by the EKF may become inaccurate or even diverge as measurement outage time gets longer because the EKF utilizes a linearization approach. However, this study shows that the UKF with the appropriate scaling parameters provides a stable and accurate relative navigation solutions despite the long measurement outage time and large initial error as compared to the relative navigation solutions of the EKF. Various navigation results have been analyzed by adjusting the scaling parameters of the UKF.

Keywords: satellite relative navigation, laser-based measurement, intermittent measurement, unscented Kalman filter

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Authors: Alasdair Warwick, Luna Dhir

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Aim: To ascertain the efficacy of overcorrecting minus lens therapy in intermittent distance exotropia. Methods: Retrospective audit of all intermittent distance exotropia patients seen in the Chelsea and Westminster Hospital pediatric eye clinic between 1st January 2014 and 1st March 2016. Change in LogMAR visual acuity, stereopsis, near and distance angles of deviation, as well as the proportions of patients converting to exophoria or undergoing strabismus surgery, were recorded. Results: 22 patients were identified, 45% male, mean age 5 years (range 0.6 to 18.5 years). The median overminus prescription was -1.0 dioptres (range -0.5 to -1.75 dioptres) and mean follow-up was 15 months (range 3 to 54 months). Visual acuity, near and distance angles of deviation improved but were not statistically significant: -0.15 LogMAR, -0.2 prism dioptres and -1.2 prism dioptres respectively (p>0.05). However, a significant change in stereopsis was observed: -74'' (p<0.01). 27% underwent strabismus surgery and 36% converted to exophoria whilst wearing their overminus prescription. Conclusions: Overcorrecting minus lens therapy is an effective therapy for intermittent distance exotropia. There was no deterioration in visual acuity and a significant improvement in stereopsis was seen in our cohort, with many patients converting to an exophoria. The proportion of patients requiring strabismus surgery was comparable to other studies. Further, follow-up is needed to ascertain long-term outcomes.

Keywords: exotropia, overcorrecting minus lens, refraction, strabismus

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Authors: Supabhorn Yimthiang, Wiyada Khanwian

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Cadmium is a heavy metal that is important in the environment because it is highly toxic. The incidence and severity of type 2 diabetes mellitus are known to be associated with cadmium. The purpose of this study was to investigate the cadmium levels in patients with type 2 diabetes mellitus at diabetes mellitus clinic, Thasala hospital, Nakhon Si Thummarat, Thailand. The study population was composed of forty five subjects. Among them, twenty two were diabetic patients and twenty three were apparently healthy non-diabetic individual subjects. After an overnight fasting, blood and morning urine samples were collected from each subject to determine fasting blood sugar and cadmium levels in urine, respectively. Systolic and diastolic blood pressure values were measured by aneroid sphygmomanometer. Study approval was taken from the human subject ethics committee of Walailak University. Verbal and written informed consent was taken from all participants. In the study samples, there were 31.8% males and 68.2% females with mean age of 47+10.53 years. The geometric mean of urine cadmium was significantly higher in diabetic patients (1.015 + 0.79 µg/g creatinine) when compared with the healthy subjects (0.395 + 0.53 µg/g creatinine) (P<0.05). This result also showed that urine cadmium excretion in diabetic patients was higher than in healthy subjects by 2.6 times. Moreover, fasting blood sugar (153+47.86 μg/dl) and systolic blood pressure (183.26+17.15 mmHg) of diabetic patients was significantly different when compared with healthy subjects (79+5.38 μg/dl and 112.78+11.32 mmHg, respectively) (P<0.05). Meanwhile, the concentration of cadmium in urine showed positive correlation with fasting plasma glucose (r=0.616) and systolic blood pressure (r=0.487). This preliminary study showed that cadmium might play an important role in the development and pathogenesis of diabetes mellitus in general population. However, these findings require confirmation through additional epidemiological and biological research.

Keywords: blood pressure, cadmium, fasting blood sugar, type 2 diabetes mellitus

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Authors: Muhammad Gillfran Samual, Rinaldy Dalimi, Fauzan Hanif Jufri, Budi Sudiarto, Ismi Rosyiana Fitri

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Solar energy is increasingly recognized as an important future energy source due to its abundant availability and renewable nature. However, the intermittent nature of solar energy can cause fluctuations in the electricity produced, making it difficult to guarantee a stable and reliable electricity supply. One solution that can be implemented is to use batteries in a photovoltaic solar power plant system with a Moving Average control algorithm, which can help smooth and reduce fluctuations in solar power output power. The parameter that can be adjusted in the Moving Average algorithm is the window size or the arithmetic average width of the photovoltaic output power over time. This research evaluates the effect of a change of window size parameter in the Moving Average algorithm on the resulting smoothed photovoltaic output power and the technical effects on batteries, i.e., power and energy usage. Based on the evaluation, it is found that the increase of window size parameter will slow down the response of photovoltaic output power to changes in irradiation and increase the smoothing quality of the intermittent photovoltaic output power. In addition, increasing the window size will reduce the maximum power received on the load side, and the amount of energy used by the battery during the power smoothing process will increase, which, in turn, increases the required battery capacity.

Keywords: battery, intermittent, moving average, photovoltaic, power smoothing

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Authors: Amany Ragab, Nashwa Khairat Abousamra, Omayma Saleh, Asmaa Higazy

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Insulin resistance syndrome has been shown to be associated with many coagulation and fibrinolytic proteins and these associations suggest that some coagulation and fibrinolytic proteins have a role in atherothrombotic disorders. This study was conducted to determine the levels of some of the haemostatic parameters in subjects having metabolic syndrome and to correlate these values with the anthropometric and metabolic variables associated with this syndrome. The study included 46 obese non diabetic subjects of whom 28 subjects(group1) fulfilled the ATP III criteria of the metabolic syndrome and 18 subjects (group2) did not have metabolic syndrome as well as 14 lean subjects (group 3) of matched age and sex as a control group. Clinical and laboratory evaluation of the study groups stressed on anthropometric measurements (weight, height, body mass index, waist circumference, and sagittal abdominal diameter), blood pressure, and laboratory measurements of fasting plasma glucose, fasting insulin, serum lipids, tissue plasminogen activator (t-PA), antithrombin III activity (ATIII), protein C and von Willebrand factor (vWf) antigen. There was significant increase in the concentrations of t-PA and vWf antigens in subjects having metabolic syndrome (group 1) in comparison to the other groups while there were non-significant changes in the levels of protein C antigen and AT III activity. Both t-PA and vWf showed significant correlation with HOMA-IR as a measure of insulin sensitivity. The t-PA showed also significant correlation with most of the variables of metabolic syndrome including waist circumference, BMI, systolic blood pressure, fasting plasma glucose, fasting insulin, and HDL cholesterol. On the other hand, vWf showed significant correlations with fasting plasma glucose, fasting insulin and sagital abdominal diameter, with non-significant correlations with the other variables. Haemostatic and fibrinolytic parameters should be included in the features and characterization of the insulin resistance syndrome. t-PA and vWf antigens concentrations were increased in subjects with metabolic syndrome and correlated with the HOMA-IR measure of insulin sensitivity. Taking into consideration that both t-PA and vWf are mainly released from vascular endothelium, these findings could be an indicator of endothelial dysfunction in that group of subjects.

Keywords: insulin resistance, obesity, metabolic syndrome, coagulation

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Authors: Sushil Kumar Singh, Vivek Tewarson, Sarvesh Kumar, Shobhit Kumar

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Objective: ‘Beating Heart coronary artery bypass grafting on Intermittent Pump Support’ is a more reliable method of coronary revascularization that takes advantage of off and on-pump CABG while eliminating the disadvantage of both techniques. Methods: From January 2015 to December 2021, a new technique, “Intermittent On pump beating heart CABG” using a suction stabilizer was used by putting aortic and venous cannulas electively in all the patients. Patients were supported by a pump intermittently, as and when required (Group 1, n=254). Retrospective data were collected from our record of the patients who underwent off-pump CABG electively by the same surgeon and team (Group 2, n=254). Results: Significant advantage was noted in Group 1 patients in terms of the number of grafts (3.31 ± 1.16 vs. 2.30 ±0.66), grafting of lateral vessels (316 vs.202), mean operating time (1.37 ± 0.23 hrs vs. 2.22 ± 0.45 hrs) and postoperative blood loss (406.30 ± 257.90 ml vs. 567.41 ± 265.20 ml).CPB support time was less than 15 minutes in the majority of patients (n=179, 70.37 %), with a mean of 16.81 minutes. It was required, particularly during the grafting of lateral vessels. A rise in enzymes level (CRP, CKMB, Trop I, and NTPro BNP) was noted in Group 1 patients. But, these did not affect the postoperative course in patients. There was no mortality in Group 1 patients, while four patients in Group 2 died. Coclusions: Intermittent on-pump CABG technique is a promising method of surgical revascularization for all patients requiring CABG. It has shown its superiority in terms of safety, the number of grafts, operating time, and better perioperative course.

Keywords: cardiopulmonary bypass, CABG, beating heart CABG, on-pump CABG

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Authors: Widyani Fatwa Dewi, Subroto Athor

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In a telecommunication service provider, quantity and interval of customer demand often difficult to predict due to high dependency on customer expansion strategy and technological development. Demand arrives when a customer needs to add capacity to an existing site or build a network in a new site. Because demand is uncertain for each period, and sometimes there is a null demand for several equipments, it is categorized as intermittent. This research aims to improve demand forecast quality in Indonesia's telecommunication service providers by using Artificial Neural Network. In Artificial Neural Network, the pattern or relationship within data will be analyzed using the training process, followed by the learning process as validation stage. Historical demand data for 36 periods is used to support this research. It is found that demand forecast by using Artificial Neural Network outperforms the existing method if it is reviewed on two criteria: the forecast accuracy, using Mean Absolute Deviation (MAD), Mean of the sum of the Squares of the Forecasting Error (MSE), Mean Error (ME) and service level which is shown through inventory cost. This research is expected to increase the reference for a telecommunication demand forecast, which is currently still limited.

Keywords: artificial neural network, demand forecast, forecast accuracy, intermittent, service level, telecommunication

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Authors: Turgay Ozgur, Bahar Ozgur, Gurcan Yazici

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The aims of the study were to investigate the relationship between the Yo-Yo intermittent recovery test level 1 (YYIR1) and relatively easy to conduct anaerobic power tests such as Sergeant (SJ) and Standing Broad Jump (SBJ), the flexibility Sit&Reach test (S&R) and Hexagon Agility (HA) test in twenty youth soccer players, aged 14 years. Players completed YYIR1 and other performance tests [(SJ), (SBJ] in two consecutive days. The mean YYIR1 distances for the players was 1454 ± 420 m. Peak Anaerobic Power (PAPw) was calculated using SJ (cm) scores. The mean PAPw was 2966,83w. Spearman’s correlation test results revealed that there is a statistically significant negative correlation between HA and YYIR1 tests (r = -0.72, p=0.000) and no significant correlation was found between anaerobic power tests and YYIR1. In conclusion, as a test to measure player’s intermittent aerobic capacity YYIR1 test and anaerobic power test results have not shown significant correlation. Although the YYIR1 test has been used in talent identification, anaerobic qualifications of player’s should be assessed using designated performance tests.

Keywords: yo-yo test, anaerobic power, soccer, sergeant jump test

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Authors: Abdolrasoul Daneshjoo

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The aim of this study was studying the effect of acute creatine supplementation on physiological variables of continuous and intermittent soccer activities of men soccer players. 32 soccer players from Tarbiat Moalem University aged (22/3+-1/6) volunteered for this research and were divided into two groups randomly. Both experimental and control groups after 6 days taking supplementation were tested. For measuring height and weight meter and balance were used. Questionnaire for health background, lactate electro, heart beat measuring polar electro, continuous and intermittent training program and time recorder were used for data collection. For data analysis descriptive statistical techniques, two-way ANOVA and F test were used. The result of this study showed increased significantly in heart rate in control group. For control group heart beat was (71/6 +- 3/5) and for experimental group it was (75/3 +- 4/9). No significant differences were observed in players weight after taking creatine.

Keywords: heartbeat, lactate Blood, creatine, soccer players of Tarbiat Moalem University

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Authors: Rady A., Elsheshai A., Elsawy M., Nagui R.

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Background and Aim: Metabolic syndrome affect around 20% of general population , authors have incriminated antipsychotics as serious risk factor that may provoke such derangement. The aim of our study is to assess metabolic syndrome in patients presenting psychotic features (delusions and hallucinations) whether schizophrenia or mood disorder and compare results in terms of drug naïf, on medication and healthy control. Subjects and Methods: The study recruited 40 schizophrenic patients, half of them drug naïf and the other half on antipsychotics, 40 patients with mood disorder with psychotic features, half of them drug naïf and the other half on medication, 20 healthy control. Exclusion criteria were put in order to exclude patients having already endocrine or metabolic disorders that my interfere with results obtain to minimize confusion bias. Metabolic syndrome assessed by measuring parameters including weight, body mass index, waist circumference, triglyceride level, HDL, fasting glucose, fasting insulin and insulin resistance Results: No difference was found when comparing drug naïf to those on medication in both schizophrenic and psychotic mood disorder arms, schizophrenic patients whether on medication or drug naïf should difference with control group for fasting glucose, schizophrenic patients on medication also showed difference in insulin resistance compared to control group. On the other hand, patients with psychotic mood disorder whether drug naïf or on medication showed difference from control group for fasting insulin level. Those on medication also differed from control for insulin resistance Conclusion: Our study didn’t reveal difference in metabolic syndrome among patients with psychotic features whether on medication or drug naïf. Only patients with Psychotic features on medication showed insulin resistance. Schizophrenic patients drug naïf or on medication tend to show higher fasting glucose while psychotic mood disorder whether drug naïf or on medication tend to show higher fasting insulin. This study suggest that presence of psychotic features themselves regardless being on medication or not carries a risk for insulin resistance and metabolic syndrome. Limitation: This study is limited by number of participants and larger numbers in future studies should be included in order to extrapolate results. Cohort longitudinal studies are needed in order to evaluate such hypothesis.

Keywords: schizophrenia, metabolic syndrome, psychosis, insulin, resistance

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Authors: Hansraj Riteesh Bookun, Cassandra Monique Hidajat

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This pilot study investigated the efficacy of a newly designed shoe which will act as an intermittent pneumatic compression device to augment venous flow in the lower limb. The aim was to assess the degree with which a wearable intermittent compression device can increase the venous flow in the popliteal vein. Background: Deep venous thrombosis and chronic venous insufficiency are relatively common problems with significant morbidity and mortality. While mechanical and chemical thromboprophylaxis measures are in place in hospital environments (in the form of TED stockings, intermittent pneumatic compression devices, analgesia, antiplatelet and anticoagulant agents), there are limited options in a community setting. Additionally, many individuals are poorly tolerant of graduated compression stockings due to the difficulty in putting them on, their constant tightness and increased associated discomfort in warm weather. These factors may hinder the management of their chronic venous insufficiency. Method: The device is lightweight, easy to wear and comfortable, with a self-contained power source. It features a Bluetooth transmitter and can be controlled with a smartphone. It is externally almost indistinguishable from a normal shoe. During activation, two bladders are inflated -one overlying the metatarsal heads and the second at the pedal arch. The resulting cyclical increase in pressure squeezes blood into the deep venous system. This will decrease periods of stasis and potentially reduce the risk of deep venous thrombosis. The shoe was fitted to 2 healthy participants and the peak systolic velocity of flow in the popliteal vein was measured during and prior to intermittent compression phases. Assessments of total flow volume were also performed. All haemodynamic assessments were performed with ultrasound by a licensed sonographer. Results: Mean peak systolic velocity of 3.5 cm/s with standard deviation of 1.3 cm/s were obtained. There was a three fold increase in mean peak systolic velocity and five fold increase in total flow volume. Conclusion: The device augments venous flow in the leg significantly. This may contribute to lowered thromboembolic risk during periods of prolonged travel or immobility. This device may also serve as an adjunct in the treatment of chronic venous insufficiency. The study will be replicated on a larger scale in a multi—centre trial.

Keywords: venous, intermittent compression, shoe, wearable device

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Authors: Chih-Yang Liao

Abstract:

Baseball is usually played outdoors in the warmest months of the year. Therefore, baseball players are susceptible to the influence of the hot environment. It has been shown that hitting performance is increased in games played in warm weather, compared to in cold weather, in Major League Baseball. Intermittent cooling during sporting events can prevent the risk of hyperthermia and increase endurance performance. However, the effects of cooling during baseball games played in a hot environment are unclear. This study adopted a cross-over design. Ten Division I collegiate male baseball players in Taiwan volunteered to participate in this study. Each player played two simulated baseball games, with one day in between. Five of the players received intermittent cooling during the first simulated game, while the other five players received intermittent cooling during the second simulated game. The participants were covered in neck and forehand regions for 6 min with towels that were soaked in icy salt water 3 to 4 times during the games. The participants received the cooling treatment in the dugout when they were not on the field for defense or hitting. During the 2 simulated games, the temperature was 31.1-34.1°C and humidity was 58.2-61.8%, with no difference between the two games. Ratings of perceived exertion, thermal sensation, tympanic and forehead skin temperature immediately after each defensive half-inning and after cooling treatments were recorded. Ratings of perceived exertion were measured using the Borg 10-point scale. The thermal sensation was measured with a 6-point scale. The tympanic and skin temperature was measured with infrared thermometers. The data were analyzed with a two-way analysis of variance with repeated measurement. The results showed that intermitted cooling significantly reduced ratings of perceived exertion and thermal sensation. Forehead skin temperature was also significantly decreased after cooling treatments. However, the tympanic temperature was not significantly different between the two trials. In conclusion, intermittent cooling in the neck and forehead regions was effective in alleviating the perceived exertion and heat sensation. However, this cooling intervention did not affect the core temperature. Whether intermittent cooling has any impact on hitting or pitching performance in baseball players warrants further investigation.

Keywords: baseball, cooling, ratings of perceived exertion, thermal sensation

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Authors: Ananya Pappu, Sneha Mishra

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Introduction: The South Asian population experiences unique health challenges that predisposes this demographic to cardiometabolic diseases at lower BMIs. South Asians may therefore benefit from recommendations specific to their cultural needs. Here, we focus on current BMI guidelines for Asians with a discussion of South Asian dietary practices and culturally tailored interventions. By integrating traditional dietary practices with modern nutritional recommendations, this manuscript aims to highlight effective strategies to improving health outcomes among South Asians. Background: The South Asian community, including individuals from India, Pakistan, Bangladesh, and Sri Lanka, experiences high rates of cardiovascular diseases, cancers, diabetes, and strokes. Notably, the prevalence of diabetes and cardiovascular disease among Asians is elevated at BMIs below the WHO's standard overweight threshold. As it stands, a BMI of 25-30 kg/m² is considered overweight in non-Asians, while this cutoff is reduced to 23-27.4 kg/m² in Asians. This discrepancy can be attributed to studies which have shown different associations between BMI and health risks in Asians compared to other populations. Given these significant challenges, optimizing lifestyle management for cardiometabolic risk factors is crucial. Tailored interventions that consider cultural context seem to be the best approach for ensuring the success of both dietary and physical activity interventions in South Asian patients. Adopting a whole food, plant-based diet (WFPD) is one such strategy. The WFPD suggests that half of one meal should consist of non-starchy vegetables. In the South Asian diet, this includes traditional vegetables such as okra, tindora, eggplant, and leafy greens including amaranth, collards, chard, and mustards. A quarter of the meal should include plant-based protein sources like cooked beans, lentils, and paneer, with the remaining quarter comprising healthy grains or starches such as whole wheat breads, millets, tapioca, and barley. Adherence to the WFPD has been shown to improve cardiometabolic risk factors including weight, BMI, total cholesterol, HbA1c, and reduces the risk of developing non-alcoholic fatty liver disease (NAFLD). Another approach to improving dietary habits is timing meals. Many of the major cultures and religions in the Indian subcontinent incorporate religious fasting. Time-restricted eating (TRE), also known as intermittent fasting, is a practice akin to traditional fasting, which involves consuming all daily calories within a specific window. TRE has been shown to improve insulin resistance in prediabetic and diabetic patients. Common regimens include completing all meals within an 8-hour window, consuming a low-calorie diet every other day, and the 5:2 diet, which involves fasting twice weekly. These fasting practices align with the natural circadian rhythm, potentially enhancing metabolic health and reducing obesity and diabetes risks. Conclusion: South Asians develop cardiometabolic disease at lower BMIs; hence, it is important to counsel patients about lifestyle interventions that decrease their risk. Traditional South Asian diets can be made more nutrient-rich by incorporating vegetables, plant proteins like lentils and beans, and substituting refined grains for whole grains. Ultimately, the best diet is one to which a patient can adhere. It is therefore important to find a regimen that aligns with a patient’s cultural and traditional food practices.

Keywords: BMI, diet, obesity, South Asian, time-restricted eating

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Authors: Ashu Rastogi, Uttam Thakur, Jimmy Pathak, Rajesh Gupta, Anil Bhansali

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Introduction: Liraglutide is known to induce weight loss and metabolic benefits in obese individuals. However, its effect after sleeve gastrectomy are not known. Methods: People with obesity (BMI>27.5 kg/m2) underwent LSG. Subsequently, participants were randomized to receive either 0.6mg liraglutide subcutaneously daily from 6 week post to be continued till 24 week (L-L group) or placebo (L-P group). Patients were assessed before surgery (baseline) and 6 weeks, 12weeks, 18weeks and 24weeks after surgery for height, weight, waist and hip circumference, BMI, body fat percentage, HbA1c, fasting C-peptide, fasting insulin, HOMA-IR, HOMA-β, GLP-1 levels (after standard OGTT). MRI abdomen was performed prior to surgery and at 24weeks post operatively for the estimation of intrapancreatic and intrahepatic fat content. Outcome measures: Primary outcomes were changes in metabolic variables of fasting and stimulated GLP-1 levels, insulin, c-peptide, plasma glucose levels. Secondary variables were indices of insulin resistance HOMA-IR, Matsuda index; and pancreatic and hepatic steatosis. Results: Thirty-eight patients undergoing LSG were screened and 29 participants were enrolled. Two patients withdrew consent and one patient died of acute coronary event. 26 patients were randomized and data analysed. Median BMI was 40.73±3.66 and 46.25±6.51; EBW of 49.225±11.14 and 651.48±4.85 in the L-P and L-L group, respectively. Baseline FPG was 132±51.48, 125±39.68; fasting insulin 21.5±13.99, 13.15±9.20, fasting GLP-1 2.4± .37, 2.4± .32, AUC GLP-1 340.78± 44 and 332.32 ± 44.1, HOMA-IR 7.0±4.2 and 4.42±4.5 in the L-P and L-L group, respectively. EBW loss was 47± 13.20 and 65.59± 24.20 (p<0.05) in the placebo versus liraglutide group. However, we did not observe inter-group difference in metabolic parameters between the groups in spite of significant intra-group changes after 6 months of LSG. Intra-pancreatic fat prior to surgery was 3.21±1.7 and 2.2±0.9 (p=0.38) that decreased to 2.14±1.8 and 1.06±0.8 (p=0.25) at 6 months in L-P and L-L group, respectively. Similarly, intra-pancreatic fat was 1.97±0.27 and 1.88±0.36 (p=0.361) at baseline that decreased to 1.14±0.44 and 1.36±0.47 (p=0.465) at 6 months in L-P and L-L group, respectively. Conclusion: Liraglutide augments extra body weight loss after sleeve gastrectomy. A decrease in intra-pancreatic and intra-hepatic fat is noticed after bariatric surgery without additive benefit of liraglutide administration.

Keywords: sleeve gastrectomy, liraglutide, intra-pancreatic fat, insulin

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Authors: Leila Yazdanpanah, Hajieh Shahbazian, Seyed Mahmoud Latifi, Armaghan Moravej Aleali, Saeed Ghanbari

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Introduction: This study was designed to determine the prevalence of diabetes in people aged over 20 years in Ahvaz, Iran. Material and Methods: The study population selected by cluster sampling. Fasting blood sugar (FBS) assessed after minimum 8 hours night fasting. A questionnaire included: age, sex, weight, height, blood pressure, waist circumference and previous history of diabetes were completed for each patient. FBS≥126mg/dl and/or oral hypoglycemic treatment and/or insulin was defined as diabetes, FBS=100-125 mg/dl as impaired fasting glucose (IFG) and FBS<100mg/dl as normal. Results: Study population was 936 persons (47.2 % male and 52.8% female). The mean age of a population was 42.2±14 years. Diabetes was detected in 15.1 % of population. Only 57cases(6.1%) were aware of their disease and 9% had unknown diabetes. Diabetes was detected in 14.5% of male (11.3% unknown and 3.2 % known diabetes) and in 11.7% of female (7% unknown and 4.7% known diabetes). Prevalence of diabetes had no significant difference (P=0.21) in male and female but unknown diabetes was significantly higher in male (P=0.025). Prevalence of diabetes was increased with rising of age between 20-60 years old but decreasing after 60 years old. Diabetes was related to age, waist circumference and systolic and diastolic blood pressure, TG level and BMI in both sex (P=0.0001). Conclusion: More than half of female and three-fourth of male diabetic patients are unaware of their disease in South of Iran. Diabetes screening should be intensified in this population.

Keywords: diabetes, prevalence, risk factor, awareness

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Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris

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Background: Unhealthy diet is one of the modifiable risk factors for developing type 2 diabetes mellitus (T2DM). Improvement in diet can be beneficial for countering diabetes. For example, HbA1c, an important biomarker for diabetes, can be reduced by 1.1% through only alteration in diet. Ramadan fasting has been reported to provide positive health benefits. However, optimal benefits are not achieved, often due to poor dietary habits and lifestyle. There is a need to better understand the dietary habits of people fasting during Ramadan, so that necessary improvements can be made to develop this form of fasting as a non-pharmacological strategy for management and prevention of T2DM. Aim: This study aimed to assess the dietary patterns of Saudi adult patients with T2DM over three different periods (before, during, and after Ramadan) and relate this to HbA1c levels. Methods: This study recruited 82 Saudi with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for the study were obtained from De Montfort University and Saudi Ministry of Health. Dietary patterns were assessed by a self-administered questionnaire in each period. This assessment included the diet type and frequency. Blood samples were collected in each period for determination of HbA1c. Results: The number of meals per day for the participants significantly decreased during Ramadan (P < 0.001). The consumption of fruit and vegetables significantly increased during Ramadan (P = 0.017). However, the consumption of sugary drinks significantly increased during and after Ramadan (P = 0.005). Approximately 60% of the patients indicated that they ate sugary foods at least once per week. The consumption of bread and rice was reported to be at least two times per week. The consumption of rice significantly reduced during Ramadan (P = 0.002). The mean HbA1c significantly varied between periods (P = 0.001), with lowest level during Ramadan compared to before and after Ramadan. The increase in the consumption of fruits and vegetables had a medium effect size on the reduction in HbA1c during Ramadan. There was a variance of 7.7% in the mean difference in HbA1c levels between groups (who changed their fruit and vegetable consumption) which can be accounted for by the increase in the consumption of fruits and vegetables. Likewise, 9.3% of the variance in the mean HbA1c difference between the groups was accounted for by a decrease in the consumption of rice. Conclusion: The increase in the frequency of fruit and vegetables intake, and especially the reduction in the frequency of rice consumption, during Ramadan produce beneficial effects in reducing HbA1c level. Therefore, further improving the dietary habits of patients with T2DM, such as reducing their sugary drinks intake, may help them to obtain greater benefits from Ramadan fasting in the management of their diabetes. It is recommended that dietary guidance is provided to the public to maximise health benefits through Ramadan fasting.

Keywords: Diabetes, Diet, Fasting, HbA1c, Ramadan

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Authors: Javier Varillas, Jorge Alcalá

Abstract:

We investigate dislocation avalanche phenomena in face-centered cubic (FCC) and body-centered cubic (BCC) crystals using massive, large-scale molecular dynamics (MD) simulations. The analysis is focused on the intermittent development of dense dislocation arrangements subjected to uniaxial tensile straining under displacement control. We employ a novel computational scheme that allows us to inject an entangled dislocation structure in periodic MD domains. We assess the emission of plastic bursts (or dislocation avalanches) in terms of the sharp stress drops detected in the stress-strain curve. The plastic activity corresponds to the sporadic operation of specific dislocation glide processes exhibiting quiescent periods between successive avalanche events. We find that the plastic intermittences in our simulations do not overlap in time under sufficiently low strain rates as dissipation operates faster than driving, where the dense dislocation networks evolve through the emission of dislocation avalanche events whose carried slip adheres to self-organized power-law distributions. These findings enable the extension of the slip distributions obtained from strict displacement-controlled micropillar compression experiments towards smaller values of slip size. Our results furnish further understanding upon the development of entangled dislocation networks in metal plasticity, including specific mechanisms of dislocation propagation and annihilation, along with the evolution of specific dislocation populations through dislocation density analyses.

Keywords: dislocations, intermittent plasticity, molecular dynamics, slip distributions

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Authors: O. Berriche, R. Ben Othmen, H. Sfar, H. Abdesslam, S. Bou Meftah, S. Bhouri, F. Mahjoub, C. Amrouche, H. Jamoussi

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Introduction: Although current evidence emphasizes a high prevalence of vitamin D deficiency and an inverse association between serum 25-hydroxyvitamin D (25-OHD) concentration and obesity, no studies have been conducted in Tunisian obese. The objectives of our study were to estimate the vitamin D deficiency in obese, identify risk factors for vitamin D deficiency, demonstrating a possible association between vitamin D levels and metabolic parameters. Methods: This was a descriptive study of 100 obese 18-65 year-old. Anthropometric measurements were determined. Fasting blood samples were assessed for the following essays : serum calcium, 25 OH vitamin D, inorganic phosphorus, fasting glucose, HDL, LDL cholesterol and triglyceride. Insulin resistance was evaluated by fasting insulin, HOMA-IR and HOMA-ß. Consumption of foods riche in vitamin D, sunscreen use, wearing protective clothes and exposed surface were assessed through applied questionnaires. Results: The deficit of vitamin D (< 30 ng/ml) among obese was 98,8%. Half of them had a rate < 10ng/ml. Environmental factors involved in vitamin D deficiency are : the veil (p = 0,001), wearing protective clothes (p = 0,04) and the exposed surface (p = 0,011) and dietary factors are represented by the daily caloric intake (p = 0,0001). The percent of fat mass was negatively related to vitamin D levels (p = 0,01) but not with BMI (p = 0,11) or waist circumference (p = 0,88). Similarly, lipid and glucose profile had no link with vitamin D. We found no relationship between Insulin resistance and vitamin D levels. Conclusion: At the end of our study, we have identified a very important vitamin D deficiency among obese. Dosage and systematic supplementation should be applied and for that physician awareness is needed.

Keywords: insulinresistance, risk factors, obesity, vitamin D

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Authors: Walaa Mohammed Saeed

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Studies suggest a crosstalk between bone and metabolism through Osteocalcin (OC), a bone-derived protein that plays an important role in regulating glucose and fat metabolism. Studies relate type II Diabetes Mellitus (DMII) with Homocysteine (Hcy) and cardiovascular diseases (CVD). This study investigates the relationship between levels of OC, Hcy, and DMII in 85 subjects of which 50 were diabetic female patients (29–65 years) and 35 healthy controls. OC and Hcy levels were measured in fasting blood samples using immunoassay analyzer. Fasting serum glucose, glycated hemoglobin, lipid profile, were estimated by automated Siemens Dimension XP auto-analyzer. A significant increase in the frequency of low OC levels (p < 0.001) and high Hcy levels (p < 0.001) was detected in diabetic patients compared to controls (chi-squared test). Using ANOVA test, patients were divided into tertiles based on plasma OC and Hcy levels; fasting serum glucose varied inversely with OC but directly with Hcy tertiles (p=0.049, p=0.033 respectively). Atherogenic Index of Plasma (AIP=Log TG/HDL) predicts that diabetic patients with 36% high and 15% intermediate cardiovascular risk had increased frequency of low OC levels compared to low-risk patients (p=0.047). Another group of diabetic patients with 39% high and 11% intermediate CVD risk had increased frequency of high Hcy levels (p=0.033). A significant negative correlation existed between OC and glucose (r = -0.318; p = 0.035) while correlation between glucose level and Hcy (r = 0.851 p=0.022) was positive. Hence, low serum OC levels and high Hcy levels were associated with impaired glucose metabolism that may increase cardiovascular risk in DMII.

Keywords: osteocalcin, homocysteine, type 2 diabetes, cardiovascular

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